To be clear, it's generally advisable to only take a prescription drug under the direction of a doctor. This isn't unique to dexamethasone.
Steroids plus eyes can lead to glaucoma. My doc won't let me use them anywhere near the face.
Steroids plus eyes can lead to glaucoma. My doc won't let me use them anywhere near the face.
I don’t even really use the term “my doctor”, I just see a doctor when I need to. I’m 30 and live in a large city, and I’ve rarely seen the same doctor more than a couple times in a row. I go in for a physical roughly once a year, and the doctor will sit and talk with me for 10 minutes or so. But otherwise if I need something checked out in between I often get seen by a PA or whatever doctor in the practice is free. I’ve never really felt encouraged by the same doctor to see them repeatedly, or to email them personally if I have a medical question like I know some people do. So when I move to a different neighborhood or something, I just end up seeing a different doctor next time.
Am I just getting bad doctors? How do you find this type of buddy doctor that becomes a long term relationship and really cares about you personally, like I hear about other people seeming to have.
If you switch jobs regularly, you will likely end up on multiple insurance plans, each with their own set of participating medical professionals. Sometimes there is overlap, often there is not.
My mom has a fairly good relationship with her doctor, but she worked in the same hospital with him for 30 years.
Doc here:
Stay in one place, go to the same guy repeatedly over time, and ideally, be really candid with them, and send them your family members. When I see half (or more) of a household, it's an entirely different dynamic. You can't buy the sort of relationship that comes of seeing someone's kids grow up, and then treating that kid. That kid is like... 5% blood relative to the doc at that point. He will never be "just a patient." Or when you treat someone and their mother - that's a different level of candor right there, because that person trusts me with their mother - that right there suggests I can be more open with them, because they won't immediately blame/hate me for news they don't like.
Time is the key, though. A lot of patients, if they get "tough love", turn around and go to a different doc. Especially the ones that say they just want to hear it straight - they are trying to convince themselves, I think. So getting to "tough love" is something that's built up over time, in both directions. (Also, studies suggest that it's somewhere between "not effective" and "actively harmful" when it comes to positively changing patient's health-related behavior, so it's not a super high priority.)
Bonus points if you go to someone that only takes cash. For a once or twice a year visit, it's not that much money (compared to, say, one month of most prescription meds), but it means they don't have to hustle you through an 8-minute visit to keep their lights on. You can only get so much of a connection with someone that's forced to hustle you out of the door - it's jarring and kind of upsetting to everyone involved, on both sides of the interaction. (When I was in training I was told pretty candidly I'd make a fantastic attending one day, if I learned to actually hustle patients fast enough to be able to afford keeping an office open. ... You can imagine, I structured my career towards cash patients only. I don't like being inaccessible to folk, but I hate it less than I hate giving people half-assed help when they're in need.)
Another good element is going to a physician that you're community-bound to in some way other than a strict transaction. Your kid's little league coach will have an entirely different relationship to you than "random doctor." That's becoming less common these days, unfortunately - with the way reimbursement is swinging, I don't know of many docs that still have time for much in the way of community activities. They exist, but they're a lot rarer than they used to be.
In fact, I would recommend going to MORE doctors if you have concerns. That's why you get second and third opinions for important medical decisions.
I have high cholesterol. My father had a heart attack around 40. His father died of a heart attack. I told all my past doctors this and I have never gotten "tough love". Maybe because I have a young looking face and I'm rail thin. Maybe because I know my family history so they assume I know the risks. I put off statins in favor of trying diet and exercise unsuccessfully until I met a doctor that finally DID more forcefully suggest a statin. I should have started taking them way sooner.
A doctor is not where to find tough love or to find a friend. A doctor is where you go for expert opinions and recommendations. Inform yourself and be responsible for your own health.
As an internist and primary care physician, he had one patient who presented with back pain and was loaded on opiates, wanting refills plus more dope. He talked with her for almost an hour (a unique privilege most don't have in today's healthcare system, and likely none will going forward) and ended up sending her home with an SSRI and a note to check back in a little while. A few weeks later she was calling the clinic's owner raving about how she felt so much better, her back didn't hurt anymore, etc. I'm not writing that to say SSRIs > opiates, just to say in her situation he correctly identified her pain was due to depression. You don't get there unless you have rapport with your doc and the time to talk with them.
The point is that you have to find a doc you like and one that can spend time with you. Unfortunately I don't know of a good way of doing that. I'd hook you up but my dad passed some years ago. I'd love to hear people's ideas on finding someone like him — I need a doc, too.